LAST ONE

Just a quick update to let everyone know where we stand.  Sarah was admitted to the room about 6 p.m. yesterday evening.  We are on a different floor and wing than we normally have been.  The previous three times we have been on the lymphoma floor, and have managed to be in the same general area all three times.  This time we are on the melanoma and sarcoma floor.  They take alot of the lymphoma and other floor overruns.  Our doctor told us there were 13 admissions to the lymphoma floor yesterday alone, which may be why we had such and extended wait.  They got the final round started at about 9:00 last night.  The first day passed by pretty much without incident.  Sarah has been feeling relatively good, and she has managed to continue to eat.  It looks to me that things are going a little better than last round thus far.  The Lord has been very gracious to us and some ways it even seems like it was only yesterday we were just getting started with the chemo.  In comparison to what some people go through, we have definitely had it easy.  Still, it has been a lot to deal with and we still have more to face.  One of the major concerns with this round is actually what will follow its completion.  Dr. Billings has been adamant about the pursuit of stem cell harvest immediately following this last round of chemo.  He wants to go ahead and do it in the event that a stem cell transplant be needed in the future.  This would be necessary if this ever did reoccur. It is not the normal protocol for stem cells to be harvested without a need for a transplant immediately.  However, Dr. Billings wants to do it now for multiple reasons.  First of all, He feels very confident that he can get very good clean stem cells now since there has never been any evidence of the cancer in the bone marrow where the cells are made.  This would eliminate the potential for being unable to do this in the future and having to find a donor.  Secondly, if in the future this transplant was necessary, Sarah would have to undergo chemo again in order to harvest the cells anyway, so it could potentially prevent a round of chemo.  Although, chemo would be necessary for a transplant anyway.  Even though this thought process has been in place since the beginning, it seems, once again, that all the proper planning has not been taken into account.  This process normally takes 4-6 weeks to meet insurance approval.  This is a must since it is very costly.  However, they just sent the application in 2 days ago, and the procedure would start as soon as Sarah's counts start to come up in about 10 days.  So, a lot is contingent upon all of this getting approved by the insurance.  As I said it is all merely a precautionary measure, and a good idea in my opinion, but this may or may not come to fruition depending on how quickly the approval comes back.  Sarah would have to have the PICC line removed from her arm and a CVC line under her collarbone put in place in order to harvest the stem cells.  It also requires double the rates of Neupogen injections, as well as an extended stay at the hospital.  If they do it they would have to start a lot of this the day after the chemo ends, so in order for Sarah not to have to go through anything extra, the approval would need to come by Monday.  They want to keep us here in the hospital until the harvest is done in order to manage Sarah's counts closely.  However, we may be able to go home a few days and then come back.  Just pray that the Lord's will be done with this matter.  If the stem cell harvest be necessary, then let it come to fruition.  If not, then allow us to come home quickly and without them doing any thing excessive in pointlessly initiating the process.  The Lord had taken care of us thus far in these matters, and I have faith He will continue to do so.  As always thank you for your love, support, and most of all, your prayers.


Josh